How can a fish teach medicine, how does diabetes result from environmental contamination, and how does environmental contamination cause illness through biological and non-biological mechanisms? I recently read “The River Is in Us: Fighting Toxics in a Mohawk Community” by Elizabeth Hoover, which prompted these questions. Hoover describes the impact of contamination and disruption of a Native American community’s environment located at Akwesasne along the St. Lawrence Seaway and bisected by the U.S.-Canada border. Akwesasne is downwind and downriver from a few sites, such as Reynolds Metals and General Motors Central Foundry, recognized as particularly hazardous to human and environmental health by federal and state governments. As a foreword, the Mohawk community at Akwesasne has a long history that this article cannot do justice to. I highly recommend reading Hoover’s book for more information on historical and cultural contexts.
RYR1 encodes the ryanodine receptor—a calcium channel found in skeletal muscles which opens in response to sarcolemma depolarization allowing calcium to move from the sarcoplasmic reticulum into the cytoplasm. Those with RYR1 mutations experience central core disease—a congenital myopathy characterized by profound muscular flaccidity. To a young medical student, this phenomenon is ‘interesting,’ a label reserved for the few and far between cases in medicine when a clear cellular mechanism produced intuitive effects phenotypically. However, no amount of intellectualization can prepare medical students for the sight of a four-year-old intubated girl sitting completely still in her room—the only movement coming from her eyes as she tracks the new presence in her space. Students may find this sight so uncanny that they quickly scan the patient’s medications to check for paralytics, already forgetting what they’ve just looked up regarding the effects of RYR1 mutations.
Students are encouraged to push this unease aside and proceed with their duties, checking with the mother for overnight updates and performing a physical exam. They diligently collect data points for the all-important presentation: one of the many metrics by which students are measured.
I always knew I wanted to become a physician, but after graduating from the University of Kansas in 2014 with a GPA and MCAT score considered “non-competitive”, I took measures to bolster my resume. With two years of employment, volunteering, shadowing and several medical school interviews under my belt, I ultimately received an envelope from the KU School of Medicine in February 2016. I Skyped my mother and sister so they could witness my life transform in real time. As I peeled back the tri-folded single sheet of paper, my eyes immediately flew to the second sentence: “Unfortunately…” I half-heartedly skimmed the rest of the letter without saying a word. My mother and sister read the shame on my face. I received several more letters just like this one in the following weeks.
A central aspect of Med Intima’s mission is to “celebrate the unique, intimate story of each individual.” More specifically, our editorial board hopes this can be a space for important conversation and discovery. To this end, we are featuring the voices and initiatives taking place at KUMC in pursuit of racial equality. Below, you will find educational resources, as well as short narratives highlighting how individuals and organizations are combatting systemic racism, sharing their stories, and improving medical education for Black students.
We hope that by engaging with this page of Med Intima, medical students will be better equipped to serve their communities as future physicians. Please note that this is far from a comprehensive list, and that we hope the resources and narratives we provide below can act as an introduction to a more open dialogue.
The United States is the only industrialized nation with a rising maternal mortality rate. These rates are not equally distributed, with Black and American Indian/Alaska Native women being 2-3 times more likely to die of pregnancy-related complications than White women. These alarming rates are not limited to those with lower socioeconomic status but transcend both class and educational level. A study in New York City showed Black women with a college education are more likely to experience life-threatening complications during delivery than a White woman who did not complete high school.
The night was young when the radio crackled to life. We couldn’t believe our luck. They told us the search and rescue missions wouldn’t start for another week, but here we had someone that couldn’t continue their hike. Eager to test our skills, we quickly gathered our supplies into the truck ambulance. When I look back on all my clinical experiences, the Philmont rotation outside of Cimarron, New Mexico, is certainly my favorite. Established in 1938 as Philturn Rocky Mountain Scout Camp, Philmont Scout Ranch has become a center for high adventure and training.1 For emergency medical technician students and medical students like me, this site offers a unique clinical training in wilderness and prehospital medicine high up in the Sangre de Cristo Mountains of the Rockies.1 Below the peaks in basecamp, the Philmont Infirmary is the central hub for this medical four-week sub-internship rotation, and it all began on my first night.
This post was adapted from the University of Washington School of Medicine: https://faculty.uwmedicine.org/55-word-stories/. Likewise, the instructions used to solicit these reflections were adapted from Sheetz, A and Fry, M The Stories, JAMA 2000 Vol 283(15)1934.
Sharing our experiences in health care, especially during intense, emotional, or stressful times increases our connectedness and well-being. Hearing stories from others helps us know we are not alone, and strengthens our community. The authenticity, compassion, creativity, and bravery of our colleagues help us access our own emotions, and helps us carry on.